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Wednesday, 28 November 2012

My MP, Dr Philip Lee has been using the bully pulpit of his office to argue that those who suffer from "lifestyle illnesses" such as those that are correlated with drinking and diet like type 2 diabetes should have their right to free prescriptions removed. Said the good doctor:

‘If you want to have doughnuts for breakfast, lunch and dinner, fine, but there’s a cost.’

This is the sort of thing that to some might seem reasonable at first glance but quickly unravels as soon as you start to look at the detail.

Firstly, how on Earth do you prove that something is a lifestyle illness? Of course Dr Lee has picked out a ridiculously extreme example of someone who eats doughnuts for breakfast, lunch and dinner. I would expect there to be pretty much nobody who does that in this country. But even if they did, how would you prove it? If they were going to have to pay for their diabetes treatment they would surely deny that their diet was so poor and that they had caused it.

Secondly, how can you even define a lifestyle illness? As my parliamentary representative will surely know illnesses are often made up of different components and have multiple causes. In some cases a pre-existing or congenital problem can be exacerbated by environmental factors. There may be some people who are susceptible to certain illnesses who will end up being punished as a result of perceived "lifestyle" components that may have had little or nothing to do with their problems.

Also whenever I hear these sort of pronouncements it is always things like diet, drinking and smoking that are fingered as the culprits. But what about those who go skiing and break a limb? Should they pay for e.g. pain medication while their leg sets? After all they chose to go skiing. Nobody made them go hurtling down a mountain on a couple of twigs. In the same way as nobody forced our fictional diabetes sufferer to gorge on doughnuts for every meal. What about someone who went jogging regularly and had a heart-attack? Should they pay for their heart medication? Nobody forced them to put that extra strain on their vital organs.

Before long you just realise how unworkable suggestions like these are. It is almost impossible to even define what a lifestyle illness is and even if you could, there are many different causes. Trying to separate out the "deserving ill" from the "undeserving ill" would be a task of Sisyphean proportions.

I'm somewhat disconcerted to discover that the man who my fellow constituents elected to parliament, a qualified doctor no less seems to not be aware of this.

Not to mention that the latest research suggests that type 2 diabetes is not actually a result of a poor diet, but that the underlying cause of diabetes also causes sugar-seeking behaviour. Still, let's not let science interfere when we're kicking people to the kerbside. Bad people, bad genes, it's all grist to the mill...